CAJ | 학술논문

目的观察二甲双胍对血清促甲状腺素(TSH)的影响.方法从2型糖尿病患者中,入选原发性甲状腺功能减退症(甲减)患者48例,组1单用二甲双胍而未予左旋甲状腺素(L-T4)替代治疗(n=17),组2给予L-T4稳定替代量的同时加用二甲双胍(n=19),组3用L-T4稳定替代量和非二甲双胍的其他降糖药(n=12).另外20例甲状腺功能正常的其他甲状腺疾病患者(组4)和30例无甲状腺疾病的患者(组5)作为对照.各组患者均定期检测血清TSH、FT3、FT4、TT3、TT4及血糖等主要指标的变化.结果治疗12个月与基线时比较,组1为(5.05±1.07)对(2.61±0.91)mU/L(P＜0.01),组2为(2.67±1.03)对(1.35±0.74)mU/L(P＜0.01),两组的FT3及FT4均无明显变化.15例TSH显著降低的患者中有13例(87%)在停用二甲双胍后8～12周内TSH由(1.30±0.71)回升至(2.58±1.02)mU/L(P＜0.01).组3、组4及组5的血清TSH和甲状腺激素的水平均无明显改变.结论服用二甲双胍可使TSH下降.
목적 관찰이갑쌍고대혈청촉갑상선소(TSH)적영향.방법종2형당뇨병환자중,입선원발성갑상선공능감퇴증(갑감)환자48례,조1단용이갑쌍고이미여좌선갑상선소(L-T4)체대치료(n=17),조2급여L-T4은정체대량적동시가용이갑쌍고(n=19),조3용L-T4은정체대량화비이갑쌍고적기타강당약(n=12).령외20례갑상선공능정상적기타갑상선질병환자(조4)화30례무갑상선질병적환자(조5)작위대조.각조환자균정기검측혈청TSH、FT3、FT4、TT3、TT4급혈당등주요지표적변화.결과 치료12개월여기선시비교,조1위(5.05±1.07)대(2.61±0.91)mU/L(P＜0.01),조2위(2.67±1.03)대(1.35±0.74)mU/L(P＜0.01),량조적FT3급FT4균무명현변화.15례TSH현저강저적환자중유13례(87%)재정용이갑쌍고후8～12주내TSH유(1.30±0.71)회승지(2.58±1.02)mU/L(P＜0.01).조3、조4급조5적혈청TSH화갑상선격소적수평균무명현개변.결론 복용이갑쌍고가사TSH하강.
Objective To evaluate the effects of metformin on thyrotropin(TSH)levels. Methods From the patients with type 2 diabetes mellitus or metabolic syndrome, 48 patients with primary hypothyroidism were enrolled and grouped. 17 patients were treated only with metformin(group A), 19 patients with metformin and stable L-T4substitution(group B), and the remaining 12 patients with antidiabetic drugs(other than metformin)and L-T4(group C). Meanwhile, 20 euthyroid patients with other thyroid abnormalities(group D)and 30 patients without thyroid diseases(group E)served as control. TSH, FT3, FT4, TT3, TT4, and blood glucose were determined regularly in all these subjects. Results After administration of metformin for 12 months, serum TSH were decreased in group A [(5.05±1.07 vs 2.61±0.91)mU/L, P＜0.01] and group B [(2.67±1.03 vs 1.35±0.74)mU/L, P＜0.01]. No difference was found in FT3and FT4in both groups. TSH levels were raised from(1.30±0.71)to(2.58±1.02)mU/L(P＜0.01)within 8～12 weeks in 13 out of 15 patients after metformin withdrawal. Serum TSH and thyroid hormones in the other 3 groups were not significantly changed. Conclusion Administration of metformin may lead to reduction of serum TSH level.